Constrictive pericarditis following cardiac surgery—Cleveland Clinic experience: report of 12 cases and review

ABSTRACT

From January 1972 to June 1983, 12 cases of confirmed constrictive pericarditis were found at the Cleveland Clinic, occurring as a long-term complication of cardiac surgery. These patients had had valve replacement, coronary artery bypass surgery, or other surgical procedures. Average time interval from initial cardiac surgery to definitive diagnosis was 12.6 months (range, 5 weeks to 34 months). Two patients were treated medically and 10 were treated surgically. Pathogenesis of pericardial constriction following cardiac surgery is unknown. Possible factors are mesothelial injury, bleeding, postpericardiotomy syndrome, and povidone-iodine irrigation. Constrictive pericarditis should be considered in the differential diagnosis of patients with right-sided heart failure after cardiac surgery.